By: Claire
Bleeding is a normal part of an abortion with pills. People undergoing an abortion with pills may commonly ask: when should bleeding start after using the pills? How long does bleeding last? How much bleeding is normal, and what should I do if I don’t experience bleeding? Today we address all of these questions and more.
Why Do Abortion Pills Cause Bleeding?
During an abortion with pills, medication causes the uterus (also known as the womb) to begin contracting. These contractions push out the contents of the uterus, including the pregnancy and all of the blood lining that had been stored inside.
There are two types of medication used during an abortion with pills: mifepristone and misoprostol (also commonly known as Cytotec). Mifepristone may or may not cause very light bleeding after use – both experiences are normal. Misoprostol, however, should always cause bleeding during an abortion with pills, as this is a major sign that the pills are working to expel the pregnancy.
When Does Bleeding Start During an Abortion With Pills?
First, it’s important to know that there is a very specific protocol that should be followed for a safe and effective abortion with pills. If you are considering using abortion pills, make sure you have access to complete information. Without accurate information on the protocols and instructions, the abortion process may be unsafe or ineffective.
When used properly, bleeding may start within 30 minutes of taking the misoprostol pills, but it can also take up to 24 hours to begin. Most people start bleeding within four to six hours of taking misoprostol.
How Much Bleeding Is Normal During An Abortion With Pills?
The amount of bleeding that occurs during an abortion with pills may vary between individuals, but expect bleeding as heavy as or heavier than a regular menstrual period. Bleeding will also be heavier in pregnancies that are further along.
In addition to bleeding, clots are also normal. In fact, you may be able to tell when the pregnancy tissue has been expelled by closely monitoring bleeding. Pregnancy tissue can look like small dark colored grapes and thin membranes; or a small sac surrounded by a light, fluffy layer. Pregnancy tissue may be more recognizable in pregnancies that are further along.
Though heavy bleeding during an abortion with pills is common, it’s important to recognize signs of a complication. Hemorrhage, or excessive bleeding that does not stop on its own, is a rare but serious risk of abortion. Seek emergency help if you notice bleeding that is heavy enough to completely soak two menstrual pads within an hour for two hours straight.
No bleeding after using the abortion pills is a sign that the pills may not have worked or there is a complication. Seek medical care if you don’t bleed or have little bleeding followed by severe pain (particularly in the right shoulder) that is not relieved by ibuprofen. This can be a sign of an ectopic pregnancy (a pregnancy that is located outside of the uterus). While this is rare, it can be life-threatening.
You can reach out to our friends at www.safe2choose.org for additional support. Their team staffs trained abortion counselors who are available to chat online or through email and may be able to help address specific questions about your abortion experience.
How Long Does Bleeding Last After An Abortion With Pills?
Bleeding is often heaviest between 4 and 6 hours after using misoprostol, though this varies by person. Bleeding should gradually lighten once the pregnancy has been expelled.
It is normal for bleeding to continue for a few weeks after an abortion with pills. The bleeding should get lighter as time goes on until it eventually disappears on its own. This bleeding is normal and- so long as there is no sign of complication- there is no need for any follow-up care, womb cleaning, or further intervention.
Menstruation should return 4-6 weeks after an abortion with pills. The first menstruation after an abortion may be slightly different from typical periods. As cycles continue, menstruation should return to its regular nature.
If you or someone you know needs more information on what to expect after taking the abortion pills or has questions about using abortion pills, you can have a chat with Ally, our safe abortion chatbot, or contact the safe abortion counsellors at safe2choose.org.